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Should all patients with psoriasis receive statins? Analysis according to different strategies
Masson, Walter; Lobo, Martín; Molinero, Graciela; Rossi, Emiliano.
  • Masson, Walter; Hospital Italiano de Buenos Aires. Cardiology Service. Buenos Aires. AR
  • Lobo, Martín; Sociedad Argentina de Cardiología. Council of Epidemiology and Cardiovascular Prevention. Buenos Aires. AR
  • Molinero, Graciela; Sociedad Argentina de Cardiología. Council of Epidemiology and Cardiovascular Prevention. Buenos Aires. AR
  • Rossi, Emiliano; Hospital Italiano de Buenos Aires. Cardiology Service. Buenos Aires. AR
An. bras. dermatol ; 94(6): 691-697, Nov.-Dec. 2019. tab, graf
Article in English | LILACS | ID: biblio-1054897
ABSTRACT
Abstract

Background:

Different strategies have been proposed for the cardiovascular risk management of patients with psoriasis.

Objective:

To estimate the cardiovascular risk and evaluate two cardiovascular prevention strategies in patients with psoriasis, analyzing which proportion of patients would be candidates to receive statin therapy.

Methods:

A retrospective cohort was selected from a secondary database. All patients >18 years with psoriasis without cardiovascular disease or lipid-lowering treatment were included. The atherosclerotic cardiovascular disease calculator (2018 American College of Cardiology/American Heart Association guidelines) and the Systematic Coronary Risk Evaluation risk calculator (2016 European Society of Cardiology/European Society of Atherosclerosis guidelines) were calculated. The SCORE risk value was adjusted by a multiplication factor of 1.5. The recommendations for the indication of statins suggested by both guidelines were analyzed.

Results:

A total of 892 patients (mean age 59.9 ± 16.5 years, 54.5% women) were included. The median atherosclerotic cardiovascular disease calculator and Systematic Coronary Risk Evaluation values were 13.4% (IQR 6.1-27.0%) and 1.9% (IQR 0.4-5.2), respectively. According to the atherosclerotic cardiovascular disease calculator, 20.1%, 11.0%, 32.9%, and 36.4% of the population was classified at low, borderline, moderate, or high risk. Applying the Systematic Coronary Risk Evaluation, 26.5%, 42.9%, 20.8%, and 9.8% of patients were stratified as having low, moderate, high, or very high risk, respectively. The proportion of subjects with statin indication was similar using both strategies 60.1% and 60.9% for the 2018 American College of Cardiology/American Heart Association and 2016 European Society of Cardiology/European Society of Atherosclerosis guidelines, respectively. Study

limitations:

This was a secondary database study. Data on the severity of psoriasis and pharmacological treatments were not included in the analysis.

Conclusion:

This population with psoriasis was mostly classified at moderate-high risk and the statin therapy indication was similar when applying the two strategies evaluated.
Subject(s)


Full text: Available Index: LILACS (Americas) Main subject: Psoriasis / Cardiovascular Diseases / Hydroxymethylglutaryl-CoA Reductase Inhibitors / Anticholesteremic Agents Type of study: Etiology study / Practice guideline / Observational study / Risk factors Limits: Adult / Aged / Female / Humans / Male Language: English Journal: An. bras. dermatol Journal subject: Dermatology Year: 2019 Type: Article Affiliation country: Argentina Institution/Affiliation country: Hospital Italiano de Buenos Aires/AR / Sociedad Argentina de Cardiología/AR

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Full text: Available Index: LILACS (Americas) Main subject: Psoriasis / Cardiovascular Diseases / Hydroxymethylglutaryl-CoA Reductase Inhibitors / Anticholesteremic Agents Type of study: Etiology study / Practice guideline / Observational study / Risk factors Limits: Adult / Aged / Female / Humans / Male Language: English Journal: An. bras. dermatol Journal subject: Dermatology Year: 2019 Type: Article Affiliation country: Argentina Institution/Affiliation country: Hospital Italiano de Buenos Aires/AR / Sociedad Argentina de Cardiología/AR